Becker's Spine Review

45 45 HEALTHCARE NEWS FTC files suit to block 2 hospital deals By Molly Gamble T he Federal Trade Commission unanimously voted to block two separate hospital transactions, one involving Saint Peter's Healthcare System and RWJBarnabas Health and the other involving HCA Healthcare and Stew- ard Health Care System, the agency an- nounced June 2. Saint Peter's Healthcare System and RWJBarnabas Health Background: Saint Peter's Healthcare System and RWJBarnabas Health, two New Jersey health systems, signed a de- finitive agreement to combine in Sep- tember 2020. e development followed the systems' move in December 2019 to explore a partnership. Saint Peter's, based in New Brunswick, includes a 478-bed teaching hospital and children's hospital. RWJBarnabas Health, headquartered in West Orange, includes 12 acute care hos- pitals, three children's hospitals and sever- al other sites of care to make it the largest academic healthcare system in New Jersey. e latest: "Saint Peter's University Hos- pital is less than one mile away from [RWJBarnabas] in New Brunswick, and they are the only two hospitals in that city," FTC Bureau of Competition Director Holly Vedova said in a June 2 news release from the agency. e FTC's complaint to block the acquisition of Saint Peter's by RWJBarnabas alleges the consolida- tion will harm competition for inpatient general acute care services in Middlesex County, resulting in a combined market share of approximately 50 percent for gen- eral acute care services in the county. Next steps: e federal court complaint and request for preliminary relief will be filed in the U.S. District Court for the Dis- trict of New Jersey to halt the transaction pending an administrative proceeding. e administrative trial is scheduled to begin on Nov. 29. HCA Healthcare and Steward Health Care System Background: Nashville, Tenn.-based HCA Healthcare announced plans to acquire five Utah hospitals from Dallas-based Steward Health Care in September 2021. Under the proposed acquisition, the five hospitals would become part of HCA Healthcare's mountain division, which has 11 hospitals throughout Utah, Idaho and Alaska. e latest: e FTC alleges the acqui- sition would eliminate the second and fourth largest healthcare systems in Utah's Wasatch Front region, where approximate- ly 80 percent of the state's residents live. Ms. Vedova with the FTC said in a June 2 news release Steward and HCA "keep costs down for consumers by competing vigorously with each other," and that com- petition would be lost under the proposed acquisition, and Steward would no longer be available to patients as a "low-cost pro- vider" in the region. e agency contends the number of healthcare systems offer- ing inpatient general acute care hospital services would decrease from three com- petitors to two in some Utah markets and from four competitors to three in others. e FTC's complaint also names Steward CEO Ralph de la Torre, MD. Next steps: e federal court complaint and request for preliminary relief will be filed in the U.S. District Court for the Dis- trict of Utah to halt the transaction pend- ing an administrative proceeding. e administrative trial is scheduled to begin on Dec. 13. In a statement shared with Becker's, Stew- ard said it is deeply disappointed by the FTC's decision. "We believe the FTC has misread the pro-competitive potential of this transaction and completely ignored the fact that the market is, in fact, domi- nated by two different major health sys- tems. e FTC's analysis is also based on antiquated methods that do not take into account such things as outpatient migra- tion patterns," the statement reads. "As such, we will continue to advocate strongly for this sale that would not only support continued investment but also ex- pand care options for communities across the state of Utah, driving down healthcare costs and continuing to increase quality. We are exploring a variety of options and upon further review, we will make a deter- mination regarding the next steps." n 441 rural hospitals at risk of losing services or closing By Andrew Cass O ut of 2,176 rural hospitals, 441 face three or more risk factors, putting them at risk of service reduction or closure, according to a May 4 Bipartisan Policy Center report. Eight things to know: 1. There were 116 rural hospital clo- sures between 2010 and 2019. 2. Federal relief over the past two years helped stabilize facilities and the pace of closures slowed. 3. That assistance was temporary, however, and rural hospitals continue to struggle financially and have had difficulty recruiting nurses and other healthcare employees. 4. Financial risk factors rural hospitals face include negative total operating margin, negative operating margin on patient services alone, negative current net assets and negative total net assets. 5. Rural hospital closures can signifi- cantly reduce access to healthcare ser- vices and also affect the availability of healthcare workers. 6. The Bipartisan Policy Center rec- ommends providing rural hospitals across-the-board Medicare spending reductions until two years after the federal COVID-19 public health emer- gency ends. 7. It recommends permanently au- thorizing the Medicare Dependent Hospital program and making rural low-volume payment adjustments permanent. 8. It recommends updating or rebas- ing Sole Community Hospital and Medicare Dependent Hospital pay- ment structures to ensure reimburse- ments are in line with current costs. n

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